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Strabismus and diplopia in a patient with acute myeloid leukemia

Patient: Male, 64 Final Diagnosis: Acute myeloid leukemia (AML) Symptoms: — Medication: — Clinical Procedure: — Specialty: — OBJECTIVE: Unusual clinical course BACKGROUND: Central nervous system (CNS) involvement is a sporadic presenting finding in patients with acute myeloid leukemia (AML) both at...

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Autores principales: Fozza, Claudio, Dore, Fausto, Isoni, Maria Antonia, Longu, Francesco, Dessì, Laura, Coppola, Lorenzo, Contini, Salvatore, Longinotti, Maurizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085118/
https://www.ncbi.nlm.nih.gov/pubmed/25006360
http://dx.doi.org/10.12659/AJCR.890526
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author Fozza, Claudio
Dore, Fausto
Isoni, Maria Antonia
Longu, Francesco
Dessì, Laura
Coppola, Lorenzo
Contini, Salvatore
Longinotti, Maurizio
author_facet Fozza, Claudio
Dore, Fausto
Isoni, Maria Antonia
Longu, Francesco
Dessì, Laura
Coppola, Lorenzo
Contini, Salvatore
Longinotti, Maurizio
author_sort Fozza, Claudio
collection PubMed
description Patient: Male, 64 Final Diagnosis: Acute myeloid leukemia (AML) Symptoms: — Medication: — Clinical Procedure: — Specialty: — OBJECTIVE: Unusual clinical course BACKGROUND: Central nervous system (CNS) involvement is a sporadic presenting finding in patients with acute myeloid leukemia (AML) both at diagnosis and at relapse. Moreover patients with CNS localization are often asymptomatic, while sometimes show meningeal signs and symptoms or, extremely rarely, signs of cranial nerve impairment. CASE REPORT: Here we report on a patient with refractory AML who suddenly developed strabismus and diplopia. Both neurological and ophtalmologic examinations were suggestive of a bilateral VI cranial nerve palsy. Noteworthy, both a cranial CT and MRI were substantially normal, while a rachicentesis was performed and cerebrospinal fluid examination was clearly suggestive of a meningeal involvement by AML. CONCLUSIONS: This is to our knowledge the first reported case in which the clinical picture of meningeal localization in an AML patient was dominated by an isolated abducens cranial nerve impairment. Moreover it highlights as unexplained strabismus and diplopia can be considered as a potential sign of CNS involvement, even if conventional imaging is negative.
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spelling pubmed-40851182014-07-08 Strabismus and diplopia in a patient with acute myeloid leukemia Fozza, Claudio Dore, Fausto Isoni, Maria Antonia Longu, Francesco Dessì, Laura Coppola, Lorenzo Contini, Salvatore Longinotti, Maurizio Am J Case Rep Articles Patient: Male, 64 Final Diagnosis: Acute myeloid leukemia (AML) Symptoms: — Medication: — Clinical Procedure: — Specialty: — OBJECTIVE: Unusual clinical course BACKGROUND: Central nervous system (CNS) involvement is a sporadic presenting finding in patients with acute myeloid leukemia (AML) both at diagnosis and at relapse. Moreover patients with CNS localization are often asymptomatic, while sometimes show meningeal signs and symptoms or, extremely rarely, signs of cranial nerve impairment. CASE REPORT: Here we report on a patient with refractory AML who suddenly developed strabismus and diplopia. Both neurological and ophtalmologic examinations were suggestive of a bilateral VI cranial nerve palsy. Noteworthy, both a cranial CT and MRI were substantially normal, while a rachicentesis was performed and cerebrospinal fluid examination was clearly suggestive of a meningeal involvement by AML. CONCLUSIONS: This is to our knowledge the first reported case in which the clinical picture of meningeal localization in an AML patient was dominated by an isolated abducens cranial nerve impairment. Moreover it highlights as unexplained strabismus and diplopia can be considered as a potential sign of CNS involvement, even if conventional imaging is negative. International Scientific Literature, Inc. 2014-07-03 /pmc/articles/PMC4085118/ /pubmed/25006360 http://dx.doi.org/10.12659/AJCR.890526 Text en © Am J Case Rep, 2014 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License
spellingShingle Articles
Fozza, Claudio
Dore, Fausto
Isoni, Maria Antonia
Longu, Francesco
Dessì, Laura
Coppola, Lorenzo
Contini, Salvatore
Longinotti, Maurizio
Strabismus and diplopia in a patient with acute myeloid leukemia
title Strabismus and diplopia in a patient with acute myeloid leukemia
title_full Strabismus and diplopia in a patient with acute myeloid leukemia
title_fullStr Strabismus and diplopia in a patient with acute myeloid leukemia
title_full_unstemmed Strabismus and diplopia in a patient with acute myeloid leukemia
title_short Strabismus and diplopia in a patient with acute myeloid leukemia
title_sort strabismus and diplopia in a patient with acute myeloid leukemia
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085118/
https://www.ncbi.nlm.nih.gov/pubmed/25006360
http://dx.doi.org/10.12659/AJCR.890526
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